| NPI | 1962955906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4590) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 233774-2) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2019-07-12 |